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0 0 0 1 <br /> 03 SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Data, OA,��,g'RETAIL ENVIRONMENTAL ENGINEERING-WEST Serlal No <br /> Sde Address Page f <br /> Z`?S G Lj Analysis Required LA13 <br /> wick _ <br /> j IQ �1{ 7y�1 3�y� CHECK ONE(q flpx OkAY CIDT TURN AWWO TIME <br /> Sheli lrnginser ! Phone No sry QW M01604ap ❑ 4481 <br /> 17— �/' �� 6 8 lavwegaslon ❑ 4441 24 hours ❑ <br /> tra%# b 7 <br /> Consultant Name A Address ,� wLoles � a sn>Iclassuva,p,al C14442 48hnui El <br /> CY <br /> f919 <br /> f1 ` �j y� 16 6a}allorrroQ <br /> fL <br /> �W fv W pazalllP� ❑ 4443 <br /> N Cnnsu last Co act Phone No _ 0 ocher ❑ <br /> N �I- f, 7�LZ[ ./ ® ca Sa91m Ram or <br /> ►�ak(n L&4k., Fax# 7br` [>��� go m_ N 061A ❑ 4462 <br /> Comments `0 °a 107L#400r tab as <br /> Wider te <br /> p 4a O m Sys <br /> soon as posAig n) <br /> p M 0 6 M ❑ 4433 24/48 ham,TAY <br /> LU ap <br /> -sampled by u�i an (M ie Z m "hot( a <br /> m w <br /> CO <br /> a d o UST AGENCY:j,A J _ <br /> Pnnled Name a a w 0 p m <br /> LU to �— m o n MATERIAL SAMPLE <br /> Sample ID Date Sludge Sol Wates Au oNoonral 0 0 � tE DE=SCRIPTION CONDITION/ <br /> 1 COMMENTS <br /> M w <br /> u _ <br /> o� <br /> CE <br /> LA` y z <br /> CE <br /> z MW3- Z4 <br /> a <br /> FYI w - ,d <br /> t <br /> Im L - (I <br /> m <br /> m , <br /> M I P� noin <br /> 04 w - Z <br /> Oki <br /> Re11nq a slurs rf e Dais Received(sipnature) Panted Name <br /> base <br /> Re ed 8 (signature) Panted Name r Time Time <br /> Time <br /> Dale liacelYad(sigrrasure) Witted Name die <br /> Thne <br /> A nqulahed 13y(signature) Ptlnied Maine Daie Rec01 (ssgnatuia Punted Nina <br /> Time ` <br /> REIT 4/13 THE LABORATORY MUST PROVIDE A COPY OF T C N -CUSTODY WITH INVOICE AND RESULTS <br /> ��1 T)me p 1 <br /> SHFLI (1N r•nHndL,iyrn.µrorr� +� <br />